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Anterior Rotation of the Right Innominate vs. Left…
We received this great question last week from a clinician who has attended a PRI course. He brought up an interesting perspective… During a conversation with a colleague a confusing issue came up. PRI stuff is interesting and one of the things that is most interesting to me is that they pretty much say “everyone has this presentation” (left anterior, tension in right hamstring, anterior tilt, etc…). If you have ever read Wolf Schamberger’s “Malalignment Syndrome”, he actually talks about the most common presentation being people anteriorly rotated on the right, posterior on the left - which is opposite to PRI’s thought process. Who is right? I think it is okay to notice trends (I have actually seen more people fall in the presentation from the Malalignment Syndrome - anterior rotation on right), but to group everyone into the same presentation is a bit strange. It’s all a matter of perspective, which is what PRI challenges the most. Humans lateralize their center of gravity to the right more than to the left because of many objective reasons. If one establishes a neuromuscular pattern of stable, secure foundation through the right lower extremity, utilizing the right vastus lateralis, right hamstring, right adductors and right gluteus medius, you will find an anteriorly positioned or oriented innominate on the right. Subsequently, the left ASIS may “feel” more anteriorly rotated on the left and possibly the evaluator may “find” the right innominate more posteriorly rotated on the right. Inter-rater reliability in these situations, without further integrated objective testing is poor at best. In this case, in standing, the evaluator would find more lumbar-thoracic lordosis on the left.
I am fairly certain, this compensatory activity associated with the human characteristic pattern of bilateral innominate anterior rotation (lumbar-thoracic lordosis) is what the “Wolf Schamberger’s Malalignment Syndrome” is all about.
PRI Illustrations by Elizabeth Cunningham
Over the past 10 weeks we have had the privilege to work with an incredible illustrator, Elizabeth Cunningham. In her short time here, she has finished several amazing illustrations that were inspired by the science behind the Postural Restoration Institute. She has also developed images for the coloring sections of our Myokinematic Restoration and Cervical-Cranio-Mandibular Restoration courses. We are sad to announce that this will be her last day here at PRI but we are happy to know our relationship will continue while she pursues a career in Boston.
Haven’t we all wondered this?In a conversation between Ron Hruska and his daughter living in New York City, Ron describes why we associate smells with memories:
Visual Midline Shift TestThe Visual Midline Shift Test is located in our Advanced Integration course manual. If you have recently been to an Advanced Integration course, you are familiar with this handout. Eric Pinkall, MPT, PRC recently caught a mistake located on the handout. Click HERE to print off the updated version of the Visual Midline Shift Test. You can see the corrections highlighted in yellow!
Who Should I Refer To?We are often asked “When should I refer my patient to a neuro-optometrist vs. an optometrist”? This issue is discussed in the Vision-Vestibular Integration Course. We have created a handout to help you determine when to refer to both! Click HERE to get a copy!
Class III and Class I BiteWe received a great email regarding treatment of an anterior class I and posterior class III bite. To read about it click here or go to Recent Emails!
Left AIC Pelvis
Look at all the asymmetry going on in this x-ray! Notice the size difference in the obturator foramens, the asymmetry in the pelvic floor opening and the difference between the left and right head of the femurs. This is a classic example of a Left AIC pelvis!
Influence of Thoracic Airflow and Rib Rotation on Transverse Spine Position
James Anderson, MPT, PRC put together a diagram that shows the influence that respiration has on rib position and spinal orientation. This handout can now be found in our Postural Respiration course when we discuss Superior T4 syndrome. To look at this handout, click here!
Right TMCC Facial Observations
Take a look at the most recent picture we have taken of a classic Right TMCC pattern! Do you see what we see?
If you are interested to learn more about this, register for a Cervical Cranio Mandibular Restoration course here!
Back in TimeFor those of you familiar with PRI, we thought you would find this intriguing. This diagram was presented in the first course given by Ron Hruska. The course was given in September of 1995 and was called “Postural Reconstruction - An Integrated Approach to Treatment of Upper Half Musculoskeletal and Respiratory Dysfunction”. This is literally, the first sketch of the Left AIC, Right BC and PEC chain!
Accelerated LocomotionIn the Left AIC patterned individual, harnessing the crossed extensor reflexes on the right and optimizing the crossed extensor reflexes on the left is encouraged. During flexion, activation occurs at the ankle (dorsiflexion), then continues up to the knee joint and the hip. This is usually often seen on the left and why some coaches ask athletes to “cock the toe” or “pull toes up”. The ankle joint is the foundation of flexion. Activation for extension starts at the hip and moves down to the knee and ankle, creating the leg drive commonly referred to as triple extension. This is often seen on the right. Which specific toe would you remove to create a functional obligatory Left AIC pattern? Click here for the answer…
Seated Acetabular Soft Tissue Kinematic InfluencesFor those of you that have taken Myokinematic Restoration, page 35 discussing seated acetabular soft tissue kinematic influences on seated FA ER and IR is somewhat confusing. Recently a therapist emailed their question regarding this page and here is James Anderson’s response…
Associated Osteokinematic and Arthrokinematic Positions
Common positions that are associated with a Left AIC pattern is a much discussed topic in all of our courses, especially Myokinematic Restoration. To help course attendees out and anyone trying to understand how the body compensates for this pattern, James Anderson, MPT, PRC created a “user friendly” handout. This diagram is now included in our Myokinematic Restoration course to help teach and educate! To access the complete handout, click here!
Pec Minor vs. Pec MajorWith all the people studying for certification this year, we have been getting some great questions! Yesterday, I received this question: “What is PRI’s stance on pec minor vs. pec major”. When discussing the pec minor vs. pec major you have to consider the right pec minor vs. the left pec major. The pec minor on the right side in a right BC pattern acts as an internal rotator with the right latissimus. The right pec minor pulls your shoulder forward and compresses your right chest wall decreasing the abilitly to get right apical expansion. When performing a right subclavious technique, you are also trying to inhibit the right pec minor. Once you have restored right humeral glenoid internal rotation, you then retrain the right subscapularis to perform right internal rotation without compensation from the right pec minor and right latissimus. In a right BC pattern, because of the orientation of the spine, the left pec major becomes tight, pulling the sternum and the shoulder girdle together. On the left, you are working to inhibit the pec major by performing a left pectoralis stretch. What a great question!
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